A novel psychotherapeutic intervention for treatment resistant depression and suicidal behaviour at the Life Promotion Clinic: Emotion Modulation Therapy

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Abstract

A novel psychotherapeutic intervention for treatment resistant depression and suicidal behaviour at the Life Promotion Clinic: Emotion Modulation Therapy. The Life Promotion Clinic is a university based outpatient clinic established in 2004 providing specialized assessment and treatment for individuals at risk of suicide. The vast majority of patients referred to this service are afflicted by mood disorders that have not responded to conventional treatment and are still manifesting high levels of suicide risk. The main focus is on providing biological and psychological treatment to reduce suicidality and to treat mental illness within a multi-disciplinary team approach. One of the goals is also to improve the effectiveness of psychological intervention in managing this difficult to treat population. In doing so, a novel mode of therapy has been developed at the Life Promotion Clinic that is producing encouraging results on a wide range of mental disorders. Emotion Modulation Therapy is a cognitive-behavioural treatment with a strong focus on principles governing performance and information processing in humans. In recent years, considerable research has been devoted to the improvement of performance in workers, especially those whose job imposes significant stress and responsibility such as in air pilots, air traffic controllers, etc. One of the basic findings is that in performing tasks, the amount of energy and information individuals can process are limited. Another important principle is that individuals possess the ability to continue to perform beyond those limits and temporarily mobilise additional effort by changing the level of activation/arousal. However, despite the benefits in being able to prolong performance manipulating the level of arousal comes at a cost with a significant impact on several other human functions. Firstly, the efficiency of performance declines progressively as fatigue and stress set in with greater amounts of effort required to produce a deteriorating performance. Secondly, there is a progressive decline in the individuals' ability to contain the amount of effort and energy being invested during performance, making them unable to prevent further escalation of stress and fatigue. According to Emotion Modulation Therapy, some mental illnesses develop whenever dysfunctional levels of emotional and mental effort are mobilized by individuals in dealing with life vicissitudes. Thus, the prime objective in ameliorating the illness is to help patients learn how to gauge and monitor the level of energy/effort invested in dealing with stressors. This intervention is characterised by a strong emphasis on self-awareness and phenomenology with motivational interviewing as a core treatment strategy. During the treatment process patients gradually acquire the ability to perform in a more efficient way achieving a dramatic reduction in symptoms of illness. This presentation will include an overview of Emotion Modulation Therapy and its features. It will also include details of its clinical application with vignettes illustrating the management of individuals with depressive illness.

Conference Title

De Gioannis A (2010). A novel psychotherapeutic intervention for treatment resistant depression and suicidal behaviour at the Life Promotion Clinic: Emotion Modulation Therapy , Invited International Speaker at 7th Meeting Japanese Society of Mood Disor